go back

South Dakota rates for HCPCS 64896

Nerve Graft Mlt Strands Hand/Foot > 4 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,366.85 / $1,366.85 / $3,511.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,160.27 / $1,366.85 / $3,394.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,422.13 / $3,153.02 / $3,941.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.78 / $2,309.98 / $4,053.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,341.32 / $2,954.28 / $11,055.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,183.58 / $3,466.99 / $7,260.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,183.58 / $2,994.11 / $3,826.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,761.96 / $2,451.17 / $2,794.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $4,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,547.48 / $2,813.60 / $3,906.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,772.40 / $3,392.10 / $3,392.10